This paper aims to stimulate the debate on the role the State takes in the development of a more supportive citizenship and health promotion. It proposes to analyze those relationships through the Theory of Donation and analytical categories such as participation and visibility. It is believed that the use of material and immaterial goods in public policies gives visibility and recognition to the users' needs, enabling the participation and the enlargement of partnerships and solidarity between State-society and society-society. This, in turn, would contribute in achieving rights, empowering health programs and materializing health conceived in a broader way. The reflections here presented come from studies of qualitative approach, which have as locus a rural community of Rio Grande do Sul state, Brazil. Data were produced through interviews, participating observations and focus groups; in the assessment of information it was adopted a thematic analysis. It was possible to see that, on one hand, when policies favor visibility and participation they allow the exercise of citizenship, the development of solidarity ties, and coping in the search of health and social needs. On the other, when they are against citizenship they can also favor immobility and clientelism, (re)producing inequalities. Finally, there has been much progress in terms of public policies, but to achieve a more supportive citizenship, the State must overcome its undemocratic practices, and society must overcome its tutored and conformist public spirit.